Appendicostomy (Malone Procedure)
Appendicostomy (Malone Procedure) is the surgical procedure that is done in patients having Anorectal Malformations or fecal incontinence due to any reason.This surgery is usually done at 8 years of age.
This surgery is done among patients who are on the enema program of the Bowel Management Program and are doing well with this. Now they are growing into adult age and want to be independent; this surgery is offered. In this surgery, the new opening for an enema is made at the child’s tummy, and Appendix is brought as a new opening so that that patient could administer the enema from this opening by himself independently.
Before Appendicostomy (Malone Procedure):
Before this surgery, we examine the child. We confirm that he/she is doing well with the enema program. We also confirm that he/she remains clean for 24 hours with it. Then, we advise some investigations of blood. We also check all previous record. Then, we repeat Ultrasound of the child. Sometimes, we may advise an X-ray of the spine of the child (If not done before).
We do this surgery through the tummy of the child. We can do it both as an open or through laparoscopy. After opening the abdomen, we bring the Appendix outside of the tummy through a small opening. We create this opening on the right half of the patient’s tummy. Usually, it takes takes about 1.5 to 2hours. We leave a catheter in this new opening.
After Appendicostomy (Malone Procedure):
- After this surgery, usually, we allow the child to feed after 4 to 6 hours. Mostly it is a Daycare surgery, and we allow the child to go home on the same day or very next day of surgery. After this surgery, usually, child does not feel much and it is not very much a problem. Usually we control it in a very well way with oral pain-killers.
- We examined the child after 15 days of surgery, and check his wound.
- After this examination, we remove the previously placed catheter.
- Then we teach the child to administer the catheter by himself into this opening and the care of this new opening.